Bariatric surgery decreases the risk of uterine malignancy

Ward, Kristy; Roncancio, Angelica M.; Shah, Nina R.; Davis, M.A.; Saenz, Cheryl C.; McHale, Michael; Plaxe, Steven C.

doi:10.1016/j.ygyno.2013.11.012

Cited by 75 publications

(39 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, endometrial cancer was one of the most common cancers and when we analysed female-specific cancer types individually we found that bariatric surgery was associated with reduced risk for endometrial cancer (HR=0.56: 95% CI 0.35–0.89; p=0.014). The preventive effect of bariatric surgery on endometrial cancer has also been observed in a retrospective cohort study by Ward et al [24]. In addition, in two recent studies, where endometrial biopsies from women with severe obesity were examined before and after gastric bypass surgery, endometrial pathology was decreased after the surgical treatment [25, 26].…”

Section: Discussionmentioning

confidence: 79%

Long-term incidence of female-specific cancer after bariatric surgery or usual care in the Swedish Obese Subjects Study

Anveden

Taube

Peltonen

et al. 2017

Gynecologic Oncology

107

View full text Add to dashboard Cite

Summary Objective To examine the long-term effects of bariatric surgery on female-specific cancer in women with obesity. Methods The prospective, matched Swedish Obese Subjects (SOS) study was designed to examine outcomes after bariatric surgery. This study includes 1420 women from the SOS cohort that underwent bariatric surgery and 1447 contemporaneously matched controls who received conventional obesity treatment. Age was 37–60 years and BMI was ≥38 kg/m2. Information on cancer events was obtained from the Swedish National Cancer Registry. Median follow-up time was 18.1 years (interquartile range 14.8–20.9 years, maximum 26 years). This study is registered with ClinicalTrials.gov, NCT01479452. Results Bariatric surgery was associated with reduced risk of overall cancer (hazard ratio=0.71; 95% CI 0.59–0.85; p<0.001). About half of the observed cancers were female-specific, and the incidence of these were lower in the surgery group compared with the control group (hazard ratio=0.68; 95% CI 0.52–0·88; p=0.004). The surgical treatment benefit with respect to female-specific cancer was significantly associated with baseline serum insulin (interaction p value=0.022), with greater relative treatment benefit in patients with medium or high insulin levels. Separate analyses of different types of female-specific cancers showed that bariatric surgery was associated with reduced risk of endometrial cancer (hazard ratio=0.56: 95% CI 0.35–0.89; p=0.014). Conclusions In this long-term study, bariatric surgery was associated with reduced risk of female-specific cancer, especially in women with hyperinsulinemia at baseline.

show abstract

Section: Discussionmentioning

confidence: 79%

Long-term incidence of female-specific cancer after bariatric surgery or usual care in the Swedish Obese Subjects Study

Anveden

Taube

Peltonen

et al. 2017

Gynecologic Oncology

107

View full text Add to dashboard Cite

show abstract

“…Postmenopausal estrogen hormonal replacement therapies are known to increase endometrial cancer risk (Allen et al 2010), and levels of estrogens in the circulation are strongly associated with an increased risk for endometrial cancer (Allen et al 2008). Bariatric surgery decreases the risk for endometrial cancer (Ward et al 2014), and a pattern of weight cycling (repeated cycles of weight loss followed by regain) has been found to be associated with increased endometrial cancer risk (Stevens et al 2012. Endometrial cancers are commonly categorized into two types.…”

Section: Endometrial Cancermentioning

confidence: 99%

Body fatness as a cause of cancer: epidemiologic clues to biologic mechanisms

Byers¹,

Sedjo²

2015

Endocrine-Related Cancer

View full text Add to dashboard Cite

Carrying excess body fat is a leading cause of cancer. Epidemiologic evidence gives strong clues about the mechanisms that link excess adiposity to risk for several cancer sites. For postmenopausal breast cancer and endometrial cancer, the hyper-estrogenic state that is induced by excess body fatness is the likely cause. For esophageal cancer and gallbladder cancer, chronic local inflammation induced by acid reflux and gallstones is the likely cause, and for liver cancer, local inflammation induced by hepatic fatty infiltration is the likely cause. However, for several other cancers known to be associated with excess adiposity, including cancers of the colon, pancreas, ovary, kidney, and prostate, specific causes are not known. Possible candidates include elevated systemic or local tissue inflammation induced by adiposity and effects of the elevated levels of leptin, insulin, IGFs, and depressed immune function that are seen with excess adiposity. There is growing evidence that intentional weight loss not only reduces circulating levels of cancer-associated factors but that it also reduces cancer incidence and recurrence. Better research is needed to understand the mechanisms that link excess body fat to cancer risk as well as to understand the amount of weight loss needed for substantial cancer risk reduction. Finally, as we develop better understanding of the mediators of the effects of excess body fatness on cancer risk, we should identify pharmacologic interventions that target those mediators so that they can be used to complement weight loss in order to reduce cancer risk.

show abstract

“…Recently, Ward and colleagues reported on a large database analysis looking at whether weight loss surgery had an effect on risk of EMCA [10]. They found that patients who had undergone weight loss surgery were less likely to develop uterine cancer.…”

Section: Discussionmentioning

confidence: 99%

“…In more recent studies, it was shown to be effective at reducing all-cause mortality and risk of cardiovascular disease [7,8]. Additionally, WLS has most recently been shown to be associated with a decreased risk of developing endometrial cancer; a retrospective cohort of women with a history of bariatric surgery were shown to be at a 71% reduced risk for developing endometrial cancer compared to those women who had not had bariatric surgery [10].…”

Section: Introductionmentioning

confidence: 99%